Percussive techniques in respiratory therapy are increasingly ordered by physicians. Patients recovering from surgery are treated with percussive techniques to prevent or minimize the onset of pneumonia or atelectasis. It is also ordered to prevent or treat the occurrence of emphysema, chronic bronchitis, cystic fibrosis, asthma, and other respiratory ailments. Percussion can be ordered in many ways, i.e., CPT or chest physiotherapy, which consists of percussion during postural drainage including coughing and/or suctioning. PVD or percussion vibration and drainage and PVS or percussion vibration and suctioning. Also used prior to percussive therapy are various inhaled medications including broncho-dilators, mucolytics and corticosteroids.
An important part of percussive techniques is administering the therapy to specific focal points on the chest wall. This procedure is also known as cupping and clapping since the therapist cups his or her hand against the patient's chest wall in rapid succession. This previous technique of using the hands had several disadvantages e.g., the direct contact of the percussor's hand with the patient's body, who may have open wounds or sores creating increased risk of contamination and infection. It was also very difficult to focus percussion on body areas where there were intravenous devices (IV), cardiac monitoring devices, chest tubes and lines for equipment or the like.
Furthermore, the hand of the therapist was really too large to properly percuss neonates and small children, since the adult hand is too large to contact only areas of specific location.
Also, there are many areas of the body which the respiratory therapist must avoid striking, e.g., kidney, spine, and breast. Therefore, complete percussive therapy could be severely limited between those areas which were occluded due to medical equipment and its attachments or sensitive body areas which had to be avoided. When it was impossible to use the hand, nurses and therapists frequently used or adapted whatever was nearby.
Therefore, in accordance with the preferred embodiments of the present invention, a hand held medical appliance comprises a partially enclosed cavity presenting a substantially circular opening bordered by an annular ring of moldably compressible material for effecting a pneumatic seal of the cavity to a body area against which it is placed. The important objective of the use of percussion in respiratory therapy is to transfer percussive waves into a body area, such as the lungs, to dislodge blocked mucus and allow it to move along to a point that the patient can expectorate it or spit it up. A non-skid finish is provided on the external surface of the appliance to keep the user's hand from slipping off. The embodiments increase the transfer of percussive energy into the desired body area while reducing the severity of the impact to the skin surface. This is accomplished by creating an excellent seal of the cavity of the appliance to the body surface. Also the cavity is designed to compress resiliently deform and compress in response to the impact pressure applied by the therapist. The annular moldable ring thus provides both a seal and provides some protection for the skin tissue at the contact point. Also, one could use the embodiments with pneumatic or electrically driven vibrator action to enhance the mucus loosening effect, or these embodiments can be used to percuss and then the body area could be vibrated.